Leptin,a peptide encoded by the obese gene,is primarily secreted by adipocytes,which is a critical hormone controlling food intake, body weight, energy expenditure and neuroendocrine function. Leptin can alter the reactivity of the gastrointestinal neuromuscular, thereby to regulate the gastric emptying and bow-el movement. Leptin seems to be a new gut hormone that has a close relationship with the function and dis-ease of gastrointestinal tract. This article reviews the relationship of leptin and gastrointestinal motility.

ObjectiveTo explore the effect of hysterescopy on the diagnosis and treatment of abnormal uterine bleeding. MethodsHysteroscopy was used in 120 cases of abnormal uterine bleeding, 98 cases with abnormal uterine cavity lesions were found. According to the different diseases, different treatments were unde~aken. ResultsThe use of hysteroscopy could make a clear diagnosis to variety of intrauterine abnormalities, and could treat many diseases at the same time directly. ConclusionUsing hysteroscopy to diagnose and treat abnormal uterine bleeding is a reliable method.

Anus fine of low rectal cancer surgery, can make the quality of Life of patients significantly im-proved,but postoperative anastomotic leakage is still the main complication, its occurrence can lead to in-creased perioperative mortality, prolonged hospitalization, increased cost, causing a great deal to patients suffering. In this paper, we review the causes and prevention of low rectal cancer after anterior resection of anastomotic leakage.

Matrix metalloproteinases (MMP) are a family of proteolytic enzymes that degrade various components of the extracellular matrix (ECM).Both animal expodments and clinical sample analysis have shown that balance in expression and activation of MMP and inhibition by tissue inhibitors of matrix metallo-proteinase (TIMP)is critical for the development of stenotic change.This review article focuses on the role of MMP relevant to restenosis after vascular injury.

Complications related to CO2 pneumoperitoneum in laparoscopy surgery have led to the devel-opment of gasless laparoscopic surgery using abdominal wall lifting technique.The technique uses facilitate laparoseopic surgery without conventional pneumoperitoneum and markly reduced in the risks of anesthesiolo-gy,especially in old patients with cardiopulmonary insufficiency.The review summarizes the application of gasless laparoscopie surgery using abdominal wall lifting technique in the field of general surgery.

Objective Investgate the anesthetic management of patients with brachiocephaliic arteritis.Methods Review and analysis the clinic data of eleven cases of brachiocephaliic arteritis.Results The process of anesthesia is smooth,and haemodynamics is stable during peri-operation.Two patients was dead of MODS.Conclusion The keys of anesthstic management of brachiocephaliic arteritis are maintaining the haemodynamics steady and the blood supply to the brain,and the protection of the brain function.

Objective to Present 56 cases of multiple primary cancers,to make improvement of diagnosis and treatment.methods A total of 58 patients with multiple primary cancers admitted from 2003 to 2007 were analysed retrospectively in Beijing Tongren Hospital.Results Thirty-five cases were males,with sex ratio of male and female 1.5:1.The median age at the onset of the first disease was 61.5 years (ranged from 27 to 86).The onset age of the two primary cancers was mainly centered around 50～75 years,while half of the second cancers occurred within five years.Conclusion the treatment and prognosis of the two primary cancers are different from that of the recurred and metastatic malignancies and shoule be handled with care.

Objective To study the surgical methods and surgical timing on Pilon fractures.Methods Retrospective analysis in accordance with fractures types and soft tissue damage degrees using different methods of internal fixation surgery for 20 eases of Pilon fractures.Results Clinical observation of all cases averaged 18 mouths,all bone healing,Ruediand-Allgawer Ⅰ type had a good rate of 100%,Ⅱ -type 80%,Ⅲ type 67%.Conclusions According to patient's age,general condition,fracture and articular surface of cartilage,the degree of soft tissue injury of different factors,we should select the appropriate surgical meth-ods and surgical timing for Pilon fractures to obtain a satisfactory outcome.

Objective This study was conducted to evaluate the effects of postoperative glutamine and growth hormone on the nutritional status,immune function,and inflammatory responses of patients undergo-ing portal hypertension surgery.Methods This study was designed as a prospective,randomized and con-trolled clinical trial.Forty-two patients undergoing portal hypertension surgery were randomly divided into 2 groups:experimental group (receiving an immune enhancing parenteral nutrition by adding glutamine and re-combinant human growth hormone,n = 22),and control group (receiving an isocaloric and isonitrogenons standard parenteral nutrition,n = 20).Parenteral nutrition providing 125 kJ · kg-1·d-1 was initiated 3 days after surgery in both groups and last for 7 days.Blood samples were obtained on day 0th,3rd,and 10th.Host nutritional status was evaluated by measuring levels of prealbumin and transferrin,immunity was evalu-ated by measuring levels of CD4,CD8,CD4/CD8,IgG,IgM and IgA,and the inflanunatory responses was determined by assessing IL-2,TNF-α and C-reactive protein (CRP) levels.Results Ten days after opera-tion,among patients receiving an immune enhancing parenteral nutrition,the serum prealbumin was (193.84±39.78)mg/L,transferrin was (2.07±0.51)mg/L,CD4 was (33.7±5.5)%,CD4/CD8 was (1.17±0.32),IgG was (13.94±1.09)g/L and IL-2 was (368.12±59.25) pg/mL.They were signifi-cantly higher than those of the control group (P < 0.05).The TNF-α concentrations was (321.12±81.42)pg/mL and CRP was (32.2±15.2)mg/mL which were significantly lower than those of the control group (P < 0.05).Conclusion Postoperative administration of immune enhancing parentearl nutrition in patients undergoing portal hypertension surgery can improve nutritional status and immune function,and modulate inflammatory response is also better than standard one.

Radiological evaluation is a key step for donor's preoperative evaluation in living donor liver transplantation(LDLT).There are many powerful functions in multi-slice computed tomography (MSCT)which can suit all-in-one radiological evaluation before donor's operation.By referring to the articles from home and abroad in recent years,from viewpoint of surgeon,this artical reviews the application status of multi-slice CT for preoperative assessment in LDLT,which can help to provide theory support for choice of radiological examination in LDLT donor.